CPHM: CONCEPT OF COMMUNITY HEALTH | UNIVERSAL HEALTH CARE Flashcards
The science and art of preventing disease, prolonging life and promoting health and efficiency through organized community effort
Public Health
An organized community effort to address the public interest in health by applying scientific and technical knowledge to prevent disease and promote health
Public Health
“The future of public health”
Institute of Medicine, 1988
ensure conditions that promote the health of the community
Mission of PH
Preventing the initial development of a disease
Examples: Immunization, reducing exposure to a risk factor
Primary prevention
Early detection of existing disease to reduce severity and complications
example: Screening for cancer
Secondary prevention
Reducing the impact of the disease
examples: Rehabilitation for stroke
Tertiary prevention
Area of Difference
Clinical/Hospital Health: Hospital wards, special clinic units in hospital
Community Health: Outside of hospital - home, school, RHU, place of work
Setting/place of practice and activities
Area of Difference
Clinical/Hospital Health: Mostly sick people; maybe limited to one group of patients
Community Health: Varied patients, representing total heath spectrum
Types of patients seen
Area of Difference
Clinical/Hospital Health: Mostly curative and rehabilitative
Community Health: Total care, whole range of services
Source of concern/range of services provided
Area of Difference
Clinical/Hospital Health: Comfort and care during illness, recovery from disease
Community Health: Promotion and maintenance of health; prevention of disease
Priority concern
Area of Difference
Clinical/Hospital Health: Individual patient
Community Health: The family, population groups, whole community
Unit or focus of care
Area of Difference
Clinical/Hospital Health: Maximum comfort, patient independence (self care), recovery
from disease, peaceful/dignified death for terminal cases
Community Health: Effective coping and self-reliance for families and the whole community
Ultimate goal
Determinants of Health
Education Access and Quality
Health Care and Quality
Neighborhood and Built Environment
Social and Community Context
Economic Stability
year when WHO members, International Conference on Primary Health Care in Alma Ata, Kazakhstan,
1977
20th Word Health Assembly
Resolution
t or f
“ the main social targets of governments and WHO in the coming decades should be the attainment by all citizens of the world by year 2000 of a level of health that will permit them to lead a socially and economically productive life”
true
“Essential health care based on practical, scientifically sound and socially acceptable methods and technology made universally accessible to individuals and families in the community through their full participation and at a cost the community or the country can afford to maintain at every stage of their development in the spirit of self-reliance and self determination”
Alma Ata Declaration of 1978
formspartof a country’s health care system
Overall socioeconomic development of a community
Primary Health Care (PHC)
First level of contact with the national health system
Primary Health Care (PHC)
health care as close as possible to where people live and work
Primary Health Care (PHC)
Four Pillars in Primary Health Care
1.Community participation
2.Inter-sectoral coordination
3.Appropriate technology
4.Support mechanism made available
is planned process whereby local groups are
clarifying and expressing their own needs and objectives and taking collective action to meet them.”
Community Participation
(t or f)
True participation means the involvement of the people concerned in:
Analysis decision-making planning,
program implementation, and
in all the activities, from search and rescue to reconstruction, that people affected by disasters undertake spontaneously without the involvement of external agencies.
true
“in a given community as many people as possible determine a common aim and work together, pooling their resources to achieve it.
a process whereby social groups are supported to crystallise their needs and are assisted to translate them into action”.
“a committed, community-driven initiative, which leads to a common goal identified by that community and broader empowerment of that community”.
Community Participation
Relationships and interactions between
• Tasks
• Functions
• Departments and
• Organizations
Multi-sectoral Linkages
promote flow of information, ideas and integration in achievement of shared objectives
Multi-sectoral Linkages
practical, scientifically sound and
Appropriate Health Technology
socially acceptable methods and technology
Appropriate Technology
practical, effective and socially
acceptable technologies that are
accessible, affordable by community and national health systems, encourage self-reliance, and result from participatory processes.
Appropriate Technology
Methods, Procedures, Techniques and Equipment that are:
Scientifically valid
Adapted to local needs
• Acceptable to users and recipients
• Maintainable with local resources
Appropriate Health Technology
- Training and HR development
- Health education and promotion
- Supervision and guidance
- Monitoring and evaluation
- Logistics/financial support
- Restructuring of infrastructure and organization
Support Systems
(t or f)
There are eight (8) elements of Primary Health Care.
• These 8 elements are also known as ‘essential health care’. They are:
E- Education
L- Locally
E- essential
M- Maternal
E- expanded
N- nutrition
T- treatment
S- sanitation
true
rural health units, their sub-centers, chest clinics, malaria eradication units, and schistosomiasis control units; puericulture centers, tuberculosis clinics, private clinics, clinics operated by large industrial firms, community hospitals, health centers and other health facilities
Primary Health Care Facilities
non-departmentalized hospitals including emergency and regional hospitals
Secondary Health Care Facilities
medical centers and large hospitals
Tertiary Health Care Facilities
Levels of Primary Health Care Workers
Village of Grassroot Health Workers
Intermediate Level Health Workers
First Line Hospital Personnel
first contacts
curative and preventive
• Community health worker, volunteers or traditional birth attendants
Village of Grassroot Health Workers
• First source; provide support
• Attends to health problems
• Medical practitioners, nurses, midwives
Intermediate Level Health Workers
• Establish close contact; back up health services
• Physician with specialty, nurses, dentists, pharmacists and other health
professionals
First Line Hospital Personnel
Levels of Health Care and Referral System
(triangle down-up)
-Barangay Health Stations
-Rural Health Unit Community Hospitals and Health Centers Private Practioners / Centers
-Emergency/District Hospitals
-Provincial/City Health Services Provincial/City Hospitals
—Regional Health Services Regional Medical Centers And Training Hospitals
—National Health Services Medical Centers Teaching and Training Hospitals
Universal Health Care
There major dimensions of coverage:
- Population coverage
- Service coverage
- Financial Coverage
All Filipinos are automatically included in the National Health Insurance Program (NHIP)
Population coverage
Health care packages (population-based / individual based)
Service coverage
Types and Composition of Health Care Provider Networks
A. Basedonnetworkownership
1. Public–Provide-wideorCity-wide
Health System
2. Private
3. Mix
National Health Insurance Program
Members with capacity to pay premiums, or those gainfully employed or self-earning professionals or workers
Direct contributors
National Health Insurance Program
Those whose PhilHealth premiums are subsidized by the government
Indirect contributors
Health Regulation and Funding
• Safety and quality of health facilities and services
• Affordability of health services, pharmaceuticals and medical devices
• Equity in the development of health facilities and provision of health benefits
Key Areas of Health Regulation under the UHC Act
Health Regulation and Funding
• Total incremental sin tax collections
• 50% of the National Government share from PAGCOR
• 40% of the Charity Fund, net of Documentary Stamp Tax payments and mandatory contributions of PCSO
• Premium contributions of members
• Annual appropriations of the DOH
• National Government subsidy
to Philhealth
• Supplemental funding
Sources of Funding for Universal Health Care
Health Regulation and Funding
• Revenue Generation
Raising and collecting resources to pay for health services
• Pooling of Funds
Redistributing risk and resources across population groups
• Purchasing of Services
Leveraging resources towards high-value services and desired provider performance
Health Financing Functions
(t or f)
Regardless of type, HCPNs are composed of
(1) primary care provider
networks (PCPNs) that serve as the initial point of contact and navigator of patients;
(2) and hospitals that deliver secondary and tertiary general health care services.
true
Primary Care Policy Framework
A. PrimaryHealthCareApproach
B. PeopleCenteredApproach
C. EquityandFairness
(t or f)
Delivering Population-based and Individual-based Health Services
A. Individual-based Health Services
1.OutpatientBenefitPackagesandotherSpecialBenefits
2.PrimaryCareBenefitPackage(KonsultaPackage)
3. InpatientBenefitPackages
4. ZBenefitPackages
true
(t or f)
Delivering Population-based and Individual-based Health Services.
B. Population-base Health Services
1. HealthPromotion
2. EpidemiologyandDiseaseSurveillance
3. DisasterRiskReductionandManagementinHealth
true
Human Resources for Health
POPULATION-BASED PRIMARY CARE
